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Access site management after aortic valvuloplasty using a suture mediated closure device: clinical experience in 4
D Marchant1, R Schwartz, L Chepurko
1Cardiology, 300 Community Drive, Manhasset, NY 11030, USA. dmarchan@nshs.edu
Insights
A novel pre-close technique using suture mediated closure devices effectively managed femoral access sites after aortic valvuloplasty. This method successfully achieved hemostasis and reduced vascular complications in four patients, improving recovery.
Area of Science:
- Cardiovascular Interventions
- Vascular Surgery
- Interventional Cardiology
Background:
- Femoral access site management post-percutaneous balloon aortic valvuloplasty (PBAV) frequently leads to vascular complications.
- Minimizing morbidity associated with large-bore arterial access is crucial for patient outcomes.
Observation:
- A novel pre-close technique was utilized for femoral access site management in four patients undergoing PBAV.
- Suture mediated closure devices were deployed before the intervention, placing sutures for a 10 French (Fr) closure device prior to expanding the site to 14 Fr.
- This facilitated adequate tissue capture for hemostasis post-sheath removal.
Findings:
- The pre-close suture technique was successful in all four patients.
- No vascular complications were observed in the study group.
- Hemostasis was successfully achieved, indicating effective closure of the femoral artery access site.
Implications:
- This pre-close method offers a promising strategy for reducing vascular complications during PBAV.
- Improved hemostasis and patient recovery were noted compared to standard closure techniques.
- Further investigation in larger cohorts is warranted to validate these findings.
Abstract:
Management of the femoral access site following percutaneous balloon aortic valvuloplasty is often associated with significant vascular morbidity. In an effort to reduce vascular complications, a novel method of suture mediated closure device deployment was employed in four patients that underwent aortic valvuloplasty at our institution. Delivery of the sutures to the access site took place prior to the intervention in all patients. This pre-close technique allowed the sutures to be placed utilizing the 10 French (Fr) closure device prior to expanding the access site to a 14 Fr size. This was done to facilitate adequate tissue capture, thereby assuring successful hemostasis following sheath removal. The technique was successful in all patients and none of the patients suffered vascular complications. This new access site management method was successful in achieving hemostasis and provided improved patient recovery in this small group of patients as compared to our usual experience.